Watch your private payer’s administrative and medical policies for guidance on when you should use preventive services modifier 33. Two payers have already issued instructions for this modifier.

You may see changes in CMS’ e-prescribing incentive programs. The Government Accountability Office (GAO) has criticized the agency for its handling of the two e-prescribing incentive programs it administers, noting that they are inconsistent with each other, create additional burdens on physicians and cause the programs to be less effective.

These charts look at E/M services billed in the office and inpatient settings (place of service codes 11 and 21 respectively) to try and isolate which of three factors has the greatest impact on denials. The factors examined are new vs. established patient, office vs. inpatient setting, and the code level.

How do you determine how many units to bill based on the number of milligrams in a drug? For example, if liquid albuterol comes in 2.5 mg/3 ml for use in the nebulizer and the CMS drug fee schedule says 1 unit. Does that mean that the entire 2.5 mg/3 ml is only equal to 1 unit or does each mg count as a unit?

You’re unlikely to have to face an onerous new rule that would require physicians to sign all clinical lab orders beginning April 1, Part B News has learned. The clinical signature requirement was set to hit Jan. 1, 2011, but was delayed after protests by physician and lab groups, including the American Clinical Laboratory Association (ACLA).

You wouldn’t have to worry about your Medicare payments falling by 30% or more until 2014 if a pay-fix provision in President Obama’s proposed budget for fiscal 2012 is enacted. Your payments would see 0% updates in 2012 and 2013, paid for by $62 billion in savings the White House expects to get out of Medicare and Medicaid.